十二指肠镜重复消毒法对经内镜逆行胰胆管造影患者术后胆管炎的预防效果

Effect of duodenoscopic repeated disinfection in prevention of postoperative cholangitis in endoscopic retrograde cholangiopancreatography patients

  • 摘要: 目的 探讨十二指肠镜重复消毒法对经内镜逆行胰胆管造影(ERCP)患者术后胆管炎的预防效果。 方法 选取接受ERCP诊治的患者206例为研究对象,分为常规消毒组和重复消毒组,每组103例。常规消毒组按照《软式内镜清洗消毒技术规范》的消毒程序进行十二指肠镜消毒,重复消毒组将常规消毒方法重复2次。评估2组十二指肠镜消毒效果和ERCP术后胆管炎发生率。 结果 十二指肠镜洗脱液培养显示,重复消毒组内腔、镜头和抬钳器部位的细菌总数均少于常规消毒组(P<0.05); 重复消毒组消毒合格率99.03%, 与常规消毒组93.20%比较,差异无统计学意义(P>0.05)。重复消毒组ERCP术后无胆管炎发生,常规消毒组出现6例(5.83%),重复消毒组ERCP术后胆管炎发生率显著低于常规消毒组(P<0.05)。 结论 十二指肠镜重复消毒法能减少微生物残留量,提高消毒清洁程度。

     

    Abstract: Objective To investigate effect of duodenoscopic repeated disinfection in the prevention of postoperative cholangitis in patients undergoing endoscopic retrograde cholangiopancreatography(ERCP). Methods A total of 206 patients who received ERCP were randomly divided into routine disinfection group and repeated disinfection group. The routine disinfection group(n=103)was given duodenoscopic disinfection according to disinfection procedure of Technical Specification for Cleaning and Disinfection of Soft Endoscope, and the repeated disinfection group was given routine disinfection method twice. The disinfection effect of duodenoscopy and the incidence of cholangitis after ERCP were evaluated. Results The total number of bacteria in the inner cavity, lens and forceps lifting device of the repeated disinfection group was lower than that of the routine disinfection group(P<0.05). The qualified rate of disinfection was 99.03% in the repeated disinfection group, and 93.20% in the routine disinfection group, but no significant difference were found in two groups(P>0.05). No patients occurred cholangitis after ERCP in the repeated disinfection group, and 6 cases with cholangitis occurred in the routine disinfection group, with a incidence rate of 5.83%. The incidence of postoperative cholangitis in the repeated disinfection group was significantly lower than that in the routine disinfection group(P<0.05). Conclusion The repeated disinfection of duodenoscopy can reduce the amount of microbial residues, and improve the degree of disinfection and cleaning.

     

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